Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 36636 | CA |
NPI | 1073830071 |
---|---|
Provider Name | Corina Isabel Rosales |
First Address | Arcadia, CA 91006-2314 |
Second Address | Arcadia, CA 91006-2314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2010 |
Last Update Date | 29/04/2010 |